Provider Demographics
NPI:1396067575
Name:TERRY L. SCHRUBB DMD PC
Entity type:Organization
Organization Name:TERRY L. SCHRUBB DMD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JAYSHREE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRUBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-957-5733
Mailing Address - Street 1:505 NASHUA RD
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-1955
Mailing Address - Country:US
Mailing Address - Phone:978-957-5733
Mailing Address - Fax:978-957-1830
Practice Address - Street 1:505 NASHUA RD
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-1955
Practice Address - Country:US
Practice Address - Phone:978-957-5733
Practice Address - Fax:978-957-1830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
No126800000XDental ProvidersDental AssistantGroup - Multi-Specialty